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General NPI Number Information
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NPI Number | 1346811890
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Entity Type | Organization
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Legal Business Name | MEDICAL IMAGING SPECIALISTS CA INC
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Dates
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Enumeration Date | 07/06/2021
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Last Update Date | 07/06/2021
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Provider Practice Location Address
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Address Line | 533 AIRPORT BLVD STE 400
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City | BURLINGAME
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State | CA
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Zip | 94010-2013
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Country | US
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Telephone | 708-929-2883
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Fax |
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Provider Business Mailing Address
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Address Line | 533 AIRPORT BLVD STE 400
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City | BURLINGAME
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State | CA
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Zip | 94010-2013
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Country | US
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Telephone | 708-929-2883
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | HAITHAM KHATTAB
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Credential |
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Telephone | 708-929-2883
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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